Racial disparities in early mortality in 1,134 young patients with acute stroke.

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Title:	Racial disparities in early mortality in 1,134 young patients with acute stroke.
Authors:	Tsivgoulis, Georgios, Putaala, Jukka, Sharma, Vijay, Balucani, Clotilde, Martin-Schild, Sheryl, Giannopoulos, Sotirios, Batala, Lokesh, Krogias, Christos, Palazzo, Paola, Shahripour, Reza, Arvaniti, Chrysa, Barlinn, Kristian, Strbian, Daniel, Haapaniemi, Elena, Flamouridou, Maria, Vadikolias, Konstantinos, Heliopoulos, Ioannis, Voumvourakis, Konstantinos, Triantafyllou, Nikos, Azarpazhooh, Mahmoud
Source:	Neurological Sciences. Jul2014, Vol. 35 Issue 7, p1041-1049. 9p.
Subjects:	Stroke, Death rate, Youth health, Blood pressure measurement, Serum, Hospital admission & discharge, Blood sugar
Abstract:	We sought to investigate potential racial disparities in early outcomes of young individuals with stroke in an international multicenter study. We evaluated consecutive patients with first-ever acute stroke aged 18-45 years from prospective databases involving 12 tertiary-care stroke centers in North America ( n = 2), Europe ( n = 6), and Asia ( n = 4). Demographics, vascular risk factors, stroke subtypes, pre-stroke functional status, stroke severity, blood pressure parameters, and serum glucose at hospital admission were documented. The outcome events of interest were 30-day mortality and 30-day favorable functional outcome (FFO) defined as modified-Rankin Scale score of 0-1. A total of 1,134 young adults (mean age 37.4 ± 7.0 years; 58.8 % men; 48.6 % Whites, 23.9 % Blacks, and 27.5 % Asians; median baseline National Institutes of Health Stroke Scale score 6 points, interquartile range 2-13) were included in the analyses. The 30-day stroke mortality and FFO rates differed ( p < 0.001) across races. After adjusting for potential confounders, race was independently associated with 30-day mortality ( p = 0.026) and 30-day FFO ( p = 0.035). Blacks had a fourfold higher odds of 30-day stroke mortality in comparison to Asians (OR 4.00; 95 % CI 1.38-11.59; p = 0.011). Whites also had an increased likelihood of 30-day stroke mortality in comparison to Asians (OR 3.59; 95 % CI 1.28-10.03; p = 0.015). Blacks had a lower odds of 30-day FFO in comparison to Whites (OR 0.57; 95 % CI 0.35-0.91; p = 0.018). Racial disparities in early outcomes following first-ever stroke in young individuals appear to be independent of other known outcome predictor variables. Whites appear to have higher likelihood of 30-day FFO and Asians have lower odds of 30-day stroke mortality. [ABSTRACT FROM AUTHOR]
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Database:	Psychology and Behavioral Sciences Collection

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Abstract:	We sought to investigate potential racial disparities in early outcomes of young individuals with stroke in an international multicenter study. We evaluated consecutive patients with first-ever acute stroke aged 18-45 years from prospective databases involving 12 tertiary-care stroke centers in North America ( n = 2), Europe ( n = 6), and Asia ( n = 4). Demographics, vascular risk factors, stroke subtypes, pre-stroke functional status, stroke severity, blood pressure parameters, and serum glucose at hospital admission were documented. The outcome events of interest were 30-day mortality and 30-day favorable functional outcome (FFO) defined as modified-Rankin Scale score of 0-1. A total of 1,134 young adults (mean age 37.4 ± 7.0 years; 58.8 % men; 48.6 % Whites, 23.9 % Blacks, and 27.5 % Asians; median baseline National Institutes of Health Stroke Scale score 6 points, interquartile range 2-13) were included in the analyses. The 30-day stroke mortality and FFO rates differed ( p < 0.001) across races. After adjusting for potential confounders, race was independently associated with 30-day mortality ( p = 0.026) and 30-day FFO ( p = 0.035). Blacks had a fourfold higher odds of 30-day stroke mortality in comparison to Asians (OR 4.00; 95 % CI 1.38-11.59; p = 0.011). Whites also had an increased likelihood of 30-day stroke mortality in comparison to Asians (OR 3.59; 95 % CI 1.28-10.03; p = 0.015). Blacks had a lower odds of 30-day FFO in comparison to Whites (OR 0.57; 95 % CI 0.35-0.91; p = 0.018). Racial disparities in early outcomes following first-ever stroke in young individuals appear to be independent of other known outcome predictor variables. Whites appear to have higher likelihood of 30-day FFO and Asians have lower odds of 30-day stroke mortality. [ABSTRACT FROM AUTHOR]
ISSN:	15901874
DOI:	10.1007/s10072-014-1640-9